139 Perceptions on the function of puberty suppression of transgender adolescents who continued or discontinued treatment, their parents, and clinicians 7 Cohen-Kettenis, & Kreukels, 2019). In addition, the ages when the adolescents visited the gender identity clinic for the first time, and the ages when they started PS differ between the group of adolescents who discontinued treatment and the group of adolescents who continued treatment. This possibly means that the adolescents in these two groups are different. Even though this is not a subject of this study, this is interesting to examine further in future research. Additionally, even though all adolescents who had discontinued treatment and agreed to participate were interviewed, and a slightly larger number of adolescents who continued treatment was interviewed, the sample size is small. Due to the small sample size, the non-participation rate and the skewed sex ratio, it is not completely certain if genuine saturation was reached. For non-participating adolescents who had discontinued treatment, PS might have fulfilled different functions compared to the adolescents that have been interviewed. We therefore encourage gathering more qualitative data of a larger sample with a more balanced sex ratio. In conclusion, this study shows that PS has various functions and is started for various reasons. This should be reflected by guidelines, leaving room for more customized care, taking the different functions and thoughts of the adolescents and parents regarding PS into account.
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